宫颈电环切除术联合保妇康栓治疗宫颈上皮内瘤变80例效果分析

Effect of loop electrosurgical excision procedure combined with Baofukangshuan on cervical intraepithelial neoplasia

目的观察宫颈电环切除术（LEEP）联合保妇康栓在治疗宫颈上皮内瘤变（CIN）中的作用。方法对2005年1月至2008年1月河南省许昌市人民医院收治，经细胞学、阴道镜定位活检、宫颈搔刮术病理检查明确诊断为CINⅠ～Ⅲ级80例患者，进行前瞻性随机对照研究。并对80例患者行LEEP前应用HCII检测高危型人乳头瘤病毒（HPV）DNA，其中40例患者术后加用保妇康栓治疗3个疗程为研究组，将单纯行LEEP的40例患者作为对照组。分别于治疗后3、6、12个月行液基细胞学检查（TCT）及阴道镜下可疑病灶活检，6、12个月HCⅡ检测以判断两组的疗效。结果80例患者随访中均无CIN残留及复发，治疗前两组各有1例HPV阴性。研究组术后6个月复查TCT5例异常．HCⅡ检测HPV35例阴性，阴性率为87．5％；术后12个月治愈率为100％。对照组术后6个月复查TCT21例异常，HCII检测HPV15例阴性，阴性率为37．5％，术后12个月复查TCT5例异常，HCII检测HPV24例阴性，治愈率为60％。术后6个月及12个月研究组与对照组治愈率比较，研究组优于对照组（P〈0．05）。结论宫颈电环切除术联合保妇康拴治疗CIN有双重阻断作用，提高了CIN患者的一次性治愈率。

Objective To observe the effect of loop electrosurgical excision procedure （LEEP） combined with Baofukangshuan on cervical intraepithelial neoplasia （CI.N）. Methods A prospective, random and control study was performed in eighty patients with CIN Ⅰ～Ⅲ. They were examined by liq- uid-based thinprep cytology test （TCT） and colposcopic site-specific biopsies to doubtful focus of infection in the third, sixth and twelfth month after treatment. Before carrying out LEEP for these patients, high-risk HPV DNA was detected by the method of HCⅡ in the patients. Forty women in the studying group were given Baofukangshuan for three courses of treatment after LEEP. The other 40 women only underwent LEEP were in the control group. Results Eighty patients were not detected residue and relapse of CIN diagnosed by colposcopy and site-specific biopsies to doubtful focus of infection. Before treating, 1 woman with negative HPV in each group. In the studying group, 5 women were abnormal detected by TCT, 35 women were negative detected by HCⅡ, the negative rate was 87.5% , at six months after operation, the cure rate was 100% at twelve months after operation. In the control group, 21 women were abnormal detected by TCT, 15 women were negative detected by HC Ⅱ, the negative rate was 37.5% at six months after operation, 5 women were abnormal detected by TCT, 24 women were negative detected by HC Ⅱ , the cure rate was 60% at twelve months alter operation. In the sixth and twelfth month after LEEP, the differences in the cure rates between the studying group and the control group were significant （ P 〈 0. 05）. Conclusions There is double interrupted effect by combining LEEP with Baofukangshuan on CIN. It can raise the cure rate of the patients with CIN.